As global temperatures continue to rise due to anthropogenic climate change, a new study has highlighted the alarming consequences of heat stress for outdoor workers. The research, published in Kidney International Reportswas conducted among salt pan workers in Tamil Nadu, India, and reveals the urgent need for adaptation strategies and improved access to healthcare to protect vulnerable individuals.
Between 2017 and 2020, 352 workers were surveyed in seven salt pans in Tamil Nadu. The workload for different functions and the classified heat stress levels were evaluated. Key indicators such as pre- and post-shift heart rate, core body temperatures, urine characteristics, sweat rates and renal function parameters were measured.
The study found that every participant had a heavy or moderate workload, and an alarmingly nearly 90% of workers worked above recommended heat exposure limits. International regulations recommend introducing regular breaks under such circumstances, but none of the salt pans examined had such breaks.
Wet bulb temperature (WBGT), a composite measure of environmental factors that influence human thermal comfort, consistently exceeded safe levels in the salt pans, especially during the summer months. The workers reported symptoms of heat stress, dehydration and urinary tract infection symptoms, likely due to excessive sweating, lack of toilet access and limited water consumption during their shifts.
Of particular interest is the impact of heat stress on kidney health. The study found that 7% of workers had a low estimated glomerular filtration rate (eGFR), an indicator of kidney function. Heat stress has been linked to several kidney-related problems, including acute kidney injury, kidney stones, chronic kidney disease and urinary tract infections.
The study was conducted by a team led by Dr. Vidhya Venugopal of the Sri Ramchandra Institute of Higher Education and Research, who is also a co-investigator of the Global Health Research Center that focuses on the intersection of non-communicable diseases and environmental change. .
“We have compelling evidence that heat stress poses significant health risks to these workers. Urgent action is needed to implement adaptation strategies and improve health care, access to sanitation and welfare services to protect vulnerable individuals. If this problem is not addressed, it will result in an increase in heat. -related diseases, especially chronic kidney disease, exacerbated by pre-existing medical conditions, and potentially devastating health consequences for workers worldwide,” said Vidhya Venugopal, Professor of Occupational and Environmental Health, Sri Ramachandra Institute of Higher Education and Research.
The study underlines the fact that these workers experience prolonged exposure to high temperatures without adequate access to adaptation strategies such as shade, rehydration and rest breaks. Additionally, many hesitate to report symptoms of heat stress for fear of job loss or retaliation. The risk is further increased for undocumented workers who do not have access to health care.
About 40% of the world’s population is exposed to consistently high ambient temperatures above 30°C all year round. India in particular faces significant risks as average temperatures increased by 0.7°C between 1901 and 2018. Projections point to a staggering 4.4°C increase by the end of the century, which will worsen the health consequences of the population.
According to The Lancet countdownheat-related deaths increased by 55% between 2000-2004 and 2017-2021, and 167.2 billion potential working hours were lost due to heat exposure in India alone.
The study highlights the urgent need for comprehensive measures to address heat-related risks for vulnerable workers. Employers should provide access to shade, water and rest breaks, and provide training on how to recognize and report heat stress symptoms.
Healthcare workers should be trained to recognize HRI symptoms and healthcare providers should be aware of the increased risk of heat-related kidney injury and educate workers on the importance of staying hydrated and avoiding prolonged exposure to high temperatures.
Government agencies play a crucial role in mitigating these risks. Guidelines and recommendations exist, such as those developed by India’s National Disaster Management Authority and the National Action Plan on Climate Change, but these must be implemented effectively. Enforcing labor laws that protect workers’ rights, promoting public awareness, and improving public health infrastructure are important steps toward minimizing the impact of heat stress on vulnerable populations.
“As temperatures continue to rise, the well-being and safety of workers in a warming world must be a priority. Adapting to the risks of heat stress requires joint efforts from employers, policy makers and public health officials. Only through coordinated action can we protect the health and livelihoods of those on the front lines of heat-exposed work,” said Prof. Vivekanand Jha, Executive Director of The George Institute for Global Health India and Co-Lead of the UK’s NIHR Global Health Research Center for Non-Communicable Diseases and Environmental Change.
Priyadarshini John et al, Heat stress: a dangerous occupational hazard for vulnerable workers, Kidney International Reports (2023). DOI: 10.1016/j.ekir.2023.05.024
Presented by George Institute for Global Health
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